Abstract：
Background: The frequency of cervical insufficiency differs among the major racial and ethnic groups, with limited data specific to Asian American and Native Hawaiian/Pacific Islander (AANHPI) subpopulations. We assessed cervical insufficiency diagnoses and related outcomes across 10 racial and ethnic groups, including disaggregated AANHPI subgroups, in a large population-based cohort. Study Design: We performed a retrospective cohort study of all singleton births between 20-42 weeks\' gestation in California from 2007 to 2018. Logistic regression models were performed to estimate the odds of cervical insufficiency and, among people with cervical insufficiency, the odds of cerclage and preterm birth according to self-reported race and ethnicity. Results: Among 5,114,470 births, 38,605 (0.8%) had a diagnosis code for cervical insufficiency. Compared with non-Hispanic White people, non-Hispanic Black people had the highest odds of cervical insufficiency (adjusted odds ratio [aOR] 3.07; 95% confidence interval [CI], 2.97, 3.18), for cerclage placement and higher odds for preterm birth. Disaggregating AANHPI subgroups showed that Indian people had the highest odds (aOR 1.94; 95% CI, 1.82, 2.07) of cervical insufficiency and had significantly higher odds of cerclage without increased odds of preterm birth; Southeast Asian people had the highest odds of preterm birth. Conclusion: Within a large, diverse population-based cohort, non-Hispanic Black people experienced the highest rates of cervical insufficiency, and among those with cervical insufficiency, had among the highest rates of cerclage and preterm birth. Among AANHPI subgroups specifically, Indian people had the highest rates of cervical insufficiency and cerclage placement, without increased rates of preterm birth; Southeast Asian people had the highest rates of preterm birth, without increased rates of cerclage. Disaggregating AANHPI subgroups identifies important differences in obstetric risk factors and outcomes.
摘要：
背景：宫颈机能不全的频率在主要种族和民族之间有所不同，特定于亚裔美国人和夏威夷原住民/太平洋岛民（AANHPI）亚群的数据有限。我们评估了10个种族和民族的宫颈机能不全诊断和相关结果，包括分类的AANHPI亚组，在一个庞大的基于人群的队列中。研究设计：我们对加利福尼亚州2007年至2018年妊娠20-42周的所有单胎新生儿进行了回顾性队列研究。采用Logistic回归模型估计宫颈机能不全的几率,在宫颈机能不全的人群中，根据自我报告的种族和种族，环扎和早产的几率。结果：在5,114,470名新生儿中，38,605（0.8％）有宫颈机能不全的诊断代码。与非西班牙裔白人相比，非西班牙裔黑人的宫颈机能不全几率最高(调整后的优势比[aOR]3.07;95%置信区间[CI],2.97,3.18),环扎放置和早产几率较高。分类的AANHPI亚组显示，印度人宫颈机能不全的几率最高（aOR1.94；95％CI，1.82，2.07），环扎的几率明显更高，而早产的几率没有增加；东南亚人早产的几率最高。结论：在一个大的，多样化的基于人群的队列，非西班牙裔黑人的宫颈机能不全发生率最高，在宫颈机能不全的患者中，环扎和早产率最高。特别是在AANHPI亚组中，印度人的宫颈机能不全和环扎术发生率最高，没有增加早产率；东南亚人早产率最高，不增加环扎率。分类AANHPI亚组可识别产科危险因素和结局的重要差异。
